Project on a Framework for Rating Evidence in Public Health (PRECEPT): structure of a draft framework

Article type
Authors
Harder T1, Takla A1, de Carvalho Gomes H2, Eckmanns T1, Ellis S3, Forland F4, James R5, Jansen A2, Meerpohl J6, Morgan A3, Rehfuess E7, Schuenemann H8, Wichmann O1, Zuiderent-Jerak T9
1Robert Koch Institute, Germany
2European Centre for Disease Prevention and Control (ECDC), Sweden
3National Institute for Health and Care Excellence (NICE), United Kingdom
4Norwegian Institute of Public Health, Norway
5Scottish Intercollegiate Guidelines Network (SIGN), United Kingdom
6German Cochrane Center, Germany
7University of Munich, Germany
8McMaster University, Canada
9Linköping University, Sweden
Abstract
Aims: The Project on a Framework for Rating Evidence in Public Health (PRECEPT) is a collaboration between European public health agencies and universities, established in 2012, that aims to establish a framework for evaluating and grading evidence in the field of infectious disease epidemiology, prevention and control. PRECEPT is funded by the European Centre for Disease Prevention and Control (ECDC). This presentation describes the structure and workflow of a draft framework.
Methods and Results: The PRECEPT framework is designed to rate scientific evidence related to four domains that are of high priority in infectious disease prevention and control: disease incidence/prevalence, risk factors for disease, diagnostics and intervention. The framework is grouped into six consecutive working steps, starting from a complex public health question and ending with an evidence statement for each relevant domain. In step 1, approaches are described for identification of relevant questions. In step 2, methodological guidance is provided for the conduct of systematic reviews for these questions. For the appraisal of methodological quality of identified individual studies, 15 different quality appraisal tools are proposed and an algorithm is given to match a given study design with an appropriate tool (step 3). In step 4, a generalized evidence grading scheme based on the GRADE methodology is provided to rate the quality of bodies of evidence for each domain. The evidence appraisal process ends with the preparation of evidence profiles and summary of finding tables (step 5) followed by preparation of an evidence summary for communication of the results (step 6). By applying this methodological framework, the user should be able to evaluate and grade scientific evidence from the four major domains in a transparent and reproducible way.
Outlook: The draft framework is currently being piloted by applying it to examples from infectious disease prevention and control. Further refinements of the methodology, as well as application to other domains, and the inclusion of a methodology for going from evidence to recommendations are planned for future versions of the framework.